Alias, Am Basheer
(2016)
8 years cohort study on short term outcome of sutureless thyroidectomy in Hospital Raja Perempuan Zainab II.
Masters thesis, Universiti Sains Malaysia.
Abstract
Background: Thyroid surgery is one of the most common surgery performed now days
with very low complication rates. The introduction of vessel sealing technology have
assisted surgeon in securing hemostasis in limited operative field and shortened the
operative time. However, surgeons are still skeptical in using this technology as there
are many important structures in close proximity to the thyroid gland. Therefore, this
study is performed to evaluate the outcome of sutureless thyroidectomy as compared to
conventional knot tying technique.
Methods: This is a retrospective cohort study of case record of patients who underwent
total thyroidectomy from 1st January 2007 to 31st December 2014 in Hospital Raja
Perempuan Zainab II, Kota Bharu, Kelantan. Those who met the inclusion criteria will
be recruited in the study. Patients were divided into two groups based on conventional
or sutureless thyroidectomy. The short term outcome post thyroidectomy were studied.
The data were analyzed using Statistical Package for the Social Sciences (SPSS).
Results: Total of 495 patients were included in this study aged between 8 and 76 years
old with mean age of 44.7(13.29) years. It comprises 70 males and 425 female. Majority
were Malays (96.6%), followed by Chinese (2.2%) and Indian (0.4%). From the total of
495 patients, 71 of them underwent sutureless thyroidectomy and 424 patients
underwent conventional thyroidectomy. The mean operative time was significantly
lower in the sutureless group (100.71 versus 121.73 min, p < 0.01). There were no
significant difference in the post-operative outcome of sutureless thyroidectomy
compared to conventional thyroidectomy in term of transient hypocalcemia (21.1%
versus 25.7%), permanent hypocalcemia (0% versus 3.1%), transient recurrent laryngeal
nerve injury (0% versus 2.8%), permanent recurrent laryngeal nerve injury (0% versus
1.4%), hematoma (0% versus 1.2%), reoperation (0% versus 0.2%), surgical site
infection (0% versus 0.5%) and tracheostomy (0% versus 0.2%). There were no
statistical significant comparing the post-operative length of stay between these 2
groups.
Conclusion: Post-operative complications in sutureless thyroidectomy were similar if
not better than conventional thyroidectomy. Therefore, sutureless thyroidectomy can be
safely practiced as it have the advantage of shorter operative time thus indirectly
improving the operating room efficiency.
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